Provider Demographics
NPI:1154486231
Name:ULMER, SUZANNE (LOTR, CHT)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:ULMER
Suffix:
Gender:F
Credentials:LOTR, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8280 YMCA PLAZA DR
Mailing Address - Street 2:STE. 3-A
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-0927
Mailing Address - Country:US
Mailing Address - Phone:225-757-0164
Mailing Address - Fax:225-757-8757
Practice Address - Street 1:8280 YMCA PLAZA DR
Practice Address - Street 2:STE. 3-A
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-0927
Practice Address - Country:US
Practice Address - Phone:225-757-0164
Practice Address - Fax:225-757-8757
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAZ12031225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist